In diet-induced obese mice with Non-alcoholic fatty liver disease (NAFLD) features, kombucha supplementation improved oral glucose tolerance and reduced fasting hyperinsulinemia; in the liver it lowered citrate synthase and phosphofructokinase-1 activities, downregulated bile acid–sensing receptors TGR5 and FXR at the gene-expression level, attenuated steatosis and collagen deposition, and restored acute insulin-induced protein kinase B (Akt) serine phosphorylation—indicating coordinated effects on hepatic carbohydrate and bile acid metabolism with histologic improvement [76]. This evidence concerns the gene NR1H4 and metabolic dysfunction-associated steatotic liver disease.